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Practical Tips for Pregnant Women with Allergies & Asthma

Asthma and other allergic problems
are among the most
common of potentially serious
illnesses complicating pregnancy.
Here are answers to some of the most
common questions women ask about
managing allergies & asthma during
pregnancy.

Will asthma have any effect on my
pregnancy and on the baby?
If uncontrolled,
severe asthma may be harmful
to the developing fetus. However, if
well-controlled, it should not have an
adverse effect on you or your baby.

How does severe, uncontrolled
asthma adversely affect the fetus?
The developing fetus depends on the
mother to supply oxygen for growth
and survival. Oxygen dissolved in her
blood is transferred through the placenta
to the fetus. Uncontrolled asthma causes
a decrease in the mother’s oxygen,
which in turn, reduces the oxygen available
to the developing fetus. This may
result in impaired fetal growth; it could
even affect the baby’s survival.

Will my asthma worsen during
pregnancy? Is there any greater risk
during labor and delivery?
Your
asthma may worsen, stay unchanged,
or possibly improve during pregnancy.
Although it cannot be accurately predicted
in a first pregnancy, asthma
usually follows the same course in
subsequent pregnancies. For reasons
not totally understood, asthma usually
improves during labor and delivery,
but even if a severe attack occurs, appropriate
treatment can be given and
complications are rare.

Is there anything that I can do
to prevent symptoms of asthma or
allergies and lessen the need for medications?
Avoid asthma triggers, such
as cigarette smoke, exposure to animals,
and dusty and damp environments. Stay
in an air-conditioned place during pollen
seasons and when the pollution index
is high. Avoid crowds where cold and
flu viruses may be prevalent. Avoid
foods or chemicals that might have
caused a reaction in the past, such as
sulfites or MSG.

The danger of providing an inadequate
supply of oxygen to your baby is a much
greater risk than taking the commonly
used asthma medications.

Can any of the medications I take
for my asthma cause harm to my
baby?
Most medications used to treat
asthma appear to be safe, especially
those that have been around for many
years and have been time tested. Unfortunately,
it is difficult to conduct
adequate studies in pregnant women
to prove the safety of drugs.

Since we cannot prove the safety
of drugs taken during pregnancy,
should I stop taking my asthma medication
as soon as I discover that I
have become pregnant?
No. A moderate
to severe asthma attack is a risk
to both you and the baby. The risks of
stopping your medication are far greater
than any potential medication-related
risk to your baby. Therefore, do not
stop your regular asthma medication
unless your doctor recommends it.

Are other medications taken for my
hay fever or other allergies also safe?
Probably. However, some minor birth
defects have been linked to certain antihistamines
and decongestants in some
studies, but study results have not been
consistent. It would be best to call your
physician before continuing antihistamines
or decongestants, even those
available over the counter.

If I become short of breath, how
can my doctor know if my baby is
getting sufficient oxygen?
There are
tests that can accurately assess the
breathing status of the mother, such
as spirometry, arterial blood gases, or
pulse oximetry. Ask your doctor about
using an inexpensive portable peak
flow meter with which you can assess
changes in the severity of your asthma
at home before you get into trouble.

Are there any medications that
should be avoided during pregnancy?
Unless a life-threatening illness dictates
their need, the following medications
should be avoided during pregnancy,
either entirely or during early or
later stages:

Sulfonamides (the “sulfa” drugs) are
safe early in pregnancy, but their use in
the last trimester might result in a jaundiced
infant.

Tetracyclines may cause skeletal and
dental deformities.

Iodine-containing drugs used as expectorants
can result in serious thyroid
disease in the newborn.

Should I continue my allergy shots
during pregnancy?
It is appropriate
to continue allergy shots during pregnancy
in women who are not having
reactions to the shots, because they may
lessen your allergic or asthma symptoms.
There is no evidence that they have any
influence on preventing allergies in the
newborn. However, it is not generally
recommended that allergy shots be
started during pregnancy.

It is extremely important to monitor
closely any asthma or allergic problems
during your pregnancy. In the vast majority
of cases, you and your child can
look forward to a good outcome, even
if your asthma is severe, so long as you
follow your doctor’s instructions carefully.
At the very first signs of breathing
difficulty, call your doctor.